Richmond PMHS, UK: 2013

Richmond map

Story supplied by Angela Caulder, Team Manager and Dramatherapist

Name of service

Primary Mental Health Worker Service (PMHS)

Richmond CAMHS

When started CAPA

In June 2011 the PCT (funders) asked Richmond Specialist CAMHS to take over the management of the PMHS as after the manager and several staff had left the service it needed systems and supervision structures to be put in place.

Service description

The service at this time had one part time administrator, one part time manager and 2.9 primary mental health workers.

CAPA experience

As Specialist CAMHS in Richmond had been the early implementer of CAPA, it made sense for the PMHS to be strongly linked to the service by also using the CAPA systems and philosophy.

The first task was to meet the team and PCT manager (with whom a strong relationship already existed) to explain my plans and to sketch out the CAPA philosophy of a user led service. This meeting went well and the remaining team, a psychology MSc graduate; an Art therapist and a Integrative Arts Psychotherapist said they were looking forward to becoming more integrated within the Specialist CAMHS team. They asked many questions about CAPA and I ordered them the book each and gave them the link to the website so they could begin reading about the approach.

Following this first meeting, things moved very quickly. We appointed a locum administrator and two other locum PMHW’s; initiated paper diaries for the choice and partnership work and discussed job planning many times during our weekly 1.5 hr meetings on a Monday morning. Some of the understood the philosophy of choice and these first appointments very quickly but struggled with understanding job planning, others grasped the new structures but kept asking questions about the why?

Choice and partnership appointments had extra travel time calculated into the job plans as the PMHS was a community based service in schools and youth centres, and although the Team undertook their admin and team meetings at specialist CAMHS, their base for networking and routine telephone calls etc. was in the local authority building.


Within 2 months CAPA had been nearly fully implemented in the service, and job plans were now understood and agreed.

The only part of the structure not implemented in a pure CAPA model way was the full booking principle after choice. We allocated partnership appointments at the weekly team meeting. This was because the PMHS had new team members and existing part-time staff who did not know each other well enough to be certain that they had the right skills for taking on a particular case. However, by the end of Specialist CAMHS management of the service in March 2012, this had moved on and the more confident members of the team were using full booking to partnership appropriately.

What do you like?

As manager I really liked the way we could set the choice capacity making it flexible for the PMHS to add in extra travelling time for appointments. Also the job planning ensured that the workers had manageable caseloads and enough time for reflective practice.

What helped?

The team were very positive about CAPA from the outset and keen to make changes in the operational processes as things had felt chaotic with no manager in place. We also had a very efficient, and warm administrator who was willing to go the extra mile in helping the PMHW’s with their administration and reminders of appointments as the team being community based rarely met except at the team meeting.

Problems and advice?

On reflection, although the process of implementing CAPA seemed relatively pain free and very fast, there were bumps on the way, for example, one PMHW putting all her partnership appointments in the partnership diary rather than just the first partnership appointment! However, because we met weekly and had CAPA on the agenda, these bumps were ironed out very quickly in hopefully a collaborative way.

3 Tips...

And finally - 3 tips to get going and keep going

My 3 tips would be get the team on board first by having sessions to understand the philosophy of putting the user at the heart of the work. Secondly, meet regularly as a team (weekly is best) to iron out any misunderstandings quickly and to flex the system. Thirdly , have collaborative job planning sessions individually and as a team so no-one feels they are doing more than their colleagues and keep talking!

CAPA compliance: 90%